Younger than 21 years old- pelvic exam only if indicated. Routine
cervical cytology and pelvic exam is done three years
after onset of sexual activity
All adolescents and 19 to 64 years old who are sexually active- should be screened for HIV
Sexually active less than 25 years old- screen for chlamydia
Sexually active adolescents- screen for gonorrhea
Urine based screening w/o speculum exam is sufficient
21 to 29 years old - annual pelvic examination and cervical
cytology.
Ages 30 to 64 years old-annual pelvic examination and cervical cytology is recommended.Decrease to evry 2 to 3 years if 3 positive results were obtained and has no history of CIN 2 and CIN 3, no diethylstilbestrol exposure,not immunocompromised and never had HIV.
Older than 65- annual pelvic exam, but may discontinue annual cervical cytology if three negative results in a row were obtained, no positive result in 10 years, immunocompetent, HIV negative,no risk for STD,no diethylstilbestrol exposure in utero and no history of cervical cancer.Evaluate need for cytology during annual pelvic exam.
Asymptomatic women who had total abdominal hysterectomy for benign indications may have no more bimanual pelvic exam and speculum insertion.May continue annual exam of external genitalia